We all know how important communication is. After all, we communicate on a daily basis through a variety of verbal and non-verbal cues.
However, for someone in the advanced stages of dementia, it’s not always easy to talk, words become mixed up and names are forgotten as speech deteriorates. Mind you, humans are excellent at non-verbal communication and
Remember, short of conducting a brain scan to see what areas of the brain are still active it’s impossible to know how much memory is retained. Even so, don’t forget that when memories are eventually lost, emotions remain so it’s vital you treat them with respect, dignity, and kindness. So what can we do when words have gone?
Well, actually there are quite a few options; from signals, to flash cards, facial expressions, and pictograms which are useful for easily reminding people. For instance, a loved one with advanced dementia may not remember what a car is, and so may become confused at the word ‘car’ but a picture of a car is easier to recall in their mind.
When it comes to non-verbal cues it’s important that you exaggerate all hand movements or facial expressions. Essentially, speech itself will be limited to you, so out loud the conversation may sound one-sided but don’t forget they’re still an active participant. They may surprise you by chiming in when you least expect it! So be sure to keep listening, as well as chattering away because communication is always a two-way process. Maintain eye contact at all times, but in a normal way so blink when it feels natural and don’t stare.
Smile! Then smile some more as that way your loved one will feel much more relaxed. Simply put, if they see that you’re happy, relaxed and having fun they’ll feel the same way. Why? Because those with dementia often look to others for support/guidance. Try not to show any annoyance or frustration as once speech has gone our ability to read body language becomes much more instinctive. Much like with small children, older people will pick up on an uncomfortable atmosphere and become angry or shut down as a result.
Consider how you’re standing, or sitting as well. Never lean over, or stand directly in front of someone who needs to crane their neck to look up. Bend, or sit right at their level so they can easily see your face. Adjust your posture, no folded arms please, and place handbags/rucksacks on the floor or out of sight. Try not to rush in, it’s far better to visit once for a couple of hours than come a few times but only have fifteen minutes to spare.
Sadly, many people with dementia end up feeling guilty about how their condition impacts others. If they feel like they’ve made you late or worse are an inconvenience they are much less likely to be responsive. Remember, don’t just observe your own behaviour either. Watch for signs that they may be getting hungry, tired or are afraid of something, or someone. Reassure them in a calm, gentle voice and repeat yourself if necessary so that they fully understand what you’re saying. Talk in simple sentences, pat their hand if they look nervous and always ask if you can hug them before doing so.
A very useful visual aid for those in the later stages of dementia are pictograms or flash cards as it’s often speech that goes before memory. The chances are someone may still remember what a bus, cup, cat or biscuit is but they can’t recall the word. Flashcards are ideal for encouraging speech, even if sentences are a little mixed up. You see, even if the words themselves are nonsense if you keep a bright smile on your face, nod and agree then they’ll feel connected to you and the conversation.
Flash cards are also great for when they may have more than one option. For example, care homes sometimes use flash cards to explain mealtime choices or different activities available to residents. They are also great little tools for reminding people about what to do at different times of the day, or what will happen if they are no longer able to do those things themselves i.e. washing, brushing hair and dressing. You can either buy pre-packed flashcards or if you’re a crafty person you can make a hand-drawn set yourself. Look for ones that are bright, colourful and display both the drawing and name of an object. You could even make a game out of it by buying identical packs and playing snap!
Lots of people worry about visiting or spending time with loved ones when communication has gone but they really shouldn’t. Effective communication isn’t all about words and phrases, it’s about getting a message across. In this case, making sure your loved one feels reassured, cared for, dignified and supported while living well with dementia.
Featured Image: Flashcards: Photo Credit: Lego.com